VA reform

Reform efforts that have sought to make VA more accountable but that have not taken into account the “Human Resources” dynamics affecting VA have foundered on those rocks. The issues of public sector unions and Civil Service reform are larger than VA but profoundly affect it, and VA is dependent on Congress for legislating those broad reforms.

Past reform efforts focused on VA health care have also foundered on the rigid “Iron Triangle.” John K. Iglehart wrote in 1985 that the “VA and its advocates represent a classic example of an ‘iron triangle’ of interests that make their way through the Washington policy swirl.” The federal agency of the VA, the congressional committees that oversee and protect its interests, and veterans’ service organizations (VSOs, many of which operate under a federal charter) make up an “Iron Triangle” more often than not.

VA facilities provide thousands of jobs in certain congressional districts. Elected officials oppose the closure of VA facilities in their districts for identical reasons they oppose the closure of military bases. No one wants to appear to be anti-veteran—especially a Senator or Representative facing reelection. VSOs command prestige and influence both in public perception and on Capitol Hill, but they are traditionally or historically hesitant about reform efforts that appear to cut anything at all.

The actual needs of veterans seeking service from VA are often in direct competition with the perceived needs of the organizations and public officials designed to serve them. Thus the genuine desire to serve veterans often gets caught in the dizzyingly complex whirlwind of perceived and unperceived bureaucratic needs and interests, with the result that well-intentioned reform efforts seem merely to replicate its predecessor’s unsuccess.